December 6 - 7, 2007 Advisory Committee Meeting
Minutes

General Discussion

Thursday, December 6, 4:30 p.m.

The Chair of the Committee, Dr. Haskell, called for general
discussion on the previous topics cancer and mental health.

Mental Health and Quality of Life IndicatorsRegarding the mental health presentation a question was asked if quality of
life indicators were from clinical populations? Roughly 80% of the studies for
psychological well being came from medical groups. Studies on sleep were
primarily self-report mechanisms and obesity was not a covariate or a control.
For self-esteem approximately 50% of the studies were of individuals deemed
healthy.

LymphedemaA question arose whether the current recommendation relative to women who
have lymphedema is not to undertake physical activity. The recommendation from
the National Lymphedema Network is very specific to upper body lymphedema in
that upper body activity is risky. The literature is weak for lower limb
lymphedema. In general, the clinical experience of lymphedema therapists is that
people who have had their lymph nodes removed in the lower extremities are given
the same recommendation as those who have had their lymph nodes removed in the
upper body. Only 4 studies have been done with women with breast cancer that
show upper body aerobic or resistance training does not cause an onset or
worsening of lyphedema. The lack of data and recommendation on individuals with
lower limb lymphedema is frustrating.

Definition of DisabledOne of the limitations in the literature that was reviewed on mental health
with patient groups is that there is a discussion as to what extent is their
condition disabling. For example an individual with a spinal cord injury may be
categorized as disabled but how do you determine which mental health conditions
are disabling. While there are a number of emerging issues it may be enough to
note those in the first iteration of physical activity guidelines but not to
dwell or attempt to tackle those issues in the first round.

Dr. Haskell recessed the meeting and asked members to re-adjourn
Friday morning.